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Protecting Your $; Getting Group Health Insurance

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Posted at 6:19 PM, Sep 08, 2021
and last updated 2021-09-08 19:58:54-04

CORPUS CHRISTI, Texas — Throughout the month of September on Action Ten News First at Four, we're speaking with local experts about health insurance.

Last week the subject was coverage thru the Affordable Care Act or Obamacare.

Today, Andy Liscano speaks with a local insurance professional about group health insurance plans offered by local employers:

  • PPO's
  • HMO's
  • High deductible Health Savings Accounts
  • Flexible Spending Accounts
  • High deductible versus low deductible

Laura Gwalthey is an insurance professional specializing in employee benefits and insurance solutions. She works primarily with the estimated 60% of. local companies offering health insurance to their employees.

"Why should you get health insurance ? Mostly because it protects you in the event of a catastrophic emergency."

Emergencies like a heart attack, or any unexpected health situation.

Notes:What You Should Know When Getting Group Health Insurance;

Notes:1. Open enrollment for Group plans is your anniversary date

Notes:2. Employers with more than 50 employees required to offer health insurance

Notes:3. 50% of cost picked up by employer.

Notes:4. HSA vs. FSA

Notes:5. PPO vs. HMO

Where Open Enrollment for Obamacare is November 1st thru December 15th, Open Enrollment for group plans is based on the date you sign up.
Your anniversary date.

Employers with more than 50 employees are required by law to offer health insurance, according to Obamacare.
Typically, the Texas Department of Insurance requires 50% of the cost to be picked up by the employer, but Gwaltney says she's found employers often contribute more than that.

Then it's up to you, the employee, to make decision on what's best for you and you family.
Let's start with choosing between a Health Savings Account, or HSA, versus a Flexible Spending Account, or FSA.
Gwaltney says "they'll offer a high deductible health plan with an option to have an HSA which is a Health Savings Account, which can only be paired with a high deductible health plan."

She further explains, an HSA is an individual account.
You, the employee, own it. You can take it with you when or if you leave your employer. She added, "you can also contribute alot more money to it tax-free than you can with a Flexible Spending Account."

Gwaltney points out a Flexible Spending Account is different in that you get the lump sum of the election amount you choose, which can be as much as $2750.00. "So you save the taxes by sheltering that in an account that's tax free. But you don't own it."

And then there's the matter of PPO's or HMO's.
A PPO gives you an in-and-out-of-network choice of doctors and other providers.
It's also more costly.

An HMO gives you a specific list of in-network providers to choose from.
But it's less expensive.

Remember, a general rule of thumb in insurance is high deductible...low premium.
Low deductible...high premium.
It's up to you.